New custom-designed treatment option for high-risk aortic aneurysms

April 1, 2014

Vascular surgeons at NewYork-Presbyterian/Weill Cornell Medical Center are investigating the use of custom-designed stent grafts for the treatment of thoracoabdominal aortic aneurysms—a potentially deadly enlargement of the main artery carrying blood from the heart to the body and vital organs—for patients deemed high risk for open surgery. The FDA-approved clinical trial aims to address the unmet need for minimally invasive stent graft devices that can provide a safe and effective treatment for patients with aneurysms located in the aorta in both the chest and abdomen. No stent graft treatment is currently commercially available for these patients.

Treatment of thoracoabdominal , complex aneurysms that span both the thoracic in the chest and the , usually consists of , which carries up to a 20 percent risk of death because of the complexity of the operation. In addition, many patients undergoing this surgery are elderly and may have other medical conditions, precluding the option of surgery or making it highly risky.

The study is led by Dr. Darren Schneider, chief of vascular and endovascular surgery at NewYork-Presbyterian/Weill Cornell Medical Center and associate professor of surgery at Weill Cornell Medical College. The stent grafts are custom designed for each patient's anatomy by the NewYork-Presbyterian/Weill Cornell study team and are manufactured by Cook Medical. The stent grafts are assembled during the operation with up to five custom- placed branches for the various critical vessels that supply blood to the kidneys, liver, intestines and other organs, allowing for a precise fit.

"What's unique about this trial is that it's with a special minimally invasive stent graft device that will now allow us to fix thoracoabdominal aortic aneurysms without the large incisions used in the traditional open surgery," said Dr. Schneider. "It's our hope that with this new technology, we can fix these complex aneurysms and spare patients from the risk of major complications and death associated with open surgery."

An aneurysm is a common condition in which a portion of the aorta becomes enlarged and weakens. It can then rupture, bleed and lead to death. For several years, surgeons have been using minimally invasive techniques to implant a stent graft—a fabric tube enmeshed in a metal framework—for repair of less complex aneurysms of the lower abdominal aorta or the descending thoracic aorta, two regions of the aorta without branch vessels that supply blood to critical abdominal organs. The stent graft is inserted through the femoral artery in the groin and advanced into the aorta using X-ray guidance. The stent graft then creates a new liner in the aorta and stops the dangerous flow of blood into the aneurysm sac, protecting the patient from a rupture.

This option, however, has not been available for thoracoabdominal aortic aneurysms, complex aneurysms that span both the thoracic aorta in the chest and the abdominal aorta and involve the part of the aorta with the critical branches that to the major abdominal organs. Based on earlier studies conducted at other medical centers, use of these branched stent grafts may make treatment of thoracoabdominal aortic aneurysms much safer for patients.

NewYork-Presbyterian/Weill Cornell is the only center in the Northeast known to have this technology. The prospective, nonrandomized study will enroll up to 30 patients over two and a half years. The first procedure in the study was performed in January 2014. Investigators will analyze the results in comparison to treated with open surgical repair of thoracoabdominal aortic aneurysms and to existing data on stent graft repair of thoracoabdominal aortic aneurysms.

Explore further: Thoracic endografts used successfully to remove tumors invading the aorta

Related Stories

Thoracic endografts used successfully to remove tumors invading the aorta

May 8, 2013
Tumors have the potential to grow locally and invade neighboring organs. Some chest tumors may invade one of the great vessels of the body, the aorta. Surgical removal of these tumors is very challenging and necessitates ...

Temple surgeon working to bring new stent for aortic aneurysms to patients in the US

January 27, 2014
Temple University Hospital (TUH) could be among the first U.S.-based hospitals to test a new device known as a multilayer stent in patients suffering from aortic aneurysm, a condition characterized by the formation of a potentially ...

URMC introduces new treatment for life-threatening aneurysms

February 8, 2013
Surgeons at the University of Rochester recently introduced a new device to treat potentially deadly aortic aneurysms in the abdomen, reducing the need for invasive surgery and a lengthy recovery. URMC's Heart and Vascular ...

Minimally invasive surgery works well for abdominal aortic aneurysms, Mayo finds

September 6, 2012
A minimally invasive procedure known as endovascular repair used for abdominal aortic aneurysms has a low rate of complications, even in high-risk patients such as those with kidney, heart or lung problems, a Mayo Clinic ...

Customized device tailored to patient's individual anatomy now used to repair abdominal aortic aneurysm without surgery

February 18, 2013
An abdominal aortic aneurysm - a bulge in the large artery that carries blood away from the heart - can be immediately life-threatening if it grows large enough to rupture. The chance of survival when it ruptures is less ...

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.